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Insurance Clerk

Location:Laredo, TX
Salary Range:$8.00 - $8.50
Exempt/Non-Exempt:Non-Exempt
Benefits:Vacation,Health Plans, Sick, and Holiday pay.
Employment Type:Full Time
Positions Needed:1
Description:Performs complex clerical work and light bookkeeping and accounting work. Uses adding machine and deals with automated patient data base and related systems. Duties include submitting third party claims to the proper agency and posting payments
Duties:• Posts payments for all third party claims to patient’s account.
• Works with the R & S in order to identify site and verify provider information necessary to process payment by site.
• Runs receipts report to verify that all payments are posted by site and that the check amount reconciles with the computer total.
• Investigates and appeals all denied third party claims:
• Determines rejection code and acts accordingly, e.g. look up medical record
• documentation; investigate and correct patient’s name, date of birth, identification
• number, etc. by calling the registration department and/or the patient.
• Initiates the appeals process by calling Medicare, Medicaid, Private Insurance companies and either appealing on line or mailing a hardcopy.
• Tracks outstanding claims utilizing “Outstanding Claims” report.
• Begins an inquiry as to their status by calling the third party companies.
• Provides the Business Office Manager a recap of all third party payments by clinic site.
• Covers the “window” and bills patients in the absence of the billing clerk.
• Submits billings for Medicare crossovers.
• Performs other duties as assigned
Qualifications:• Graduate from an accredited high school or GED graduate.
• Two years technical/vocational school in Business Administration or
• Two years experience in this field.
• Bilingual in English and Spanish.


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